JENNIFER MOLDOVAN


Address: 2500 Nesconset Hwy, Building 3c, Stony Brook, NY 11790-2555
Phone: 6317512400

JENNIFER MOLDOVAN (NPI# 1811160559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1811160559
Entity Type Individual
Full Name JENNIFER MOLDOVAN
Credential P.A.
Practice Address 2500 Nesconset Hwy
Building 3c
Stony Brook
NY 11790-2555
Practice Telephone 6317512400
Practice Fax Number 6317518323
Mailing Telephone 6317512400
Mailing Fax Number 6317518323
Enumeration Date 2008-04-02
Last Update Date 2008-04-02
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
012498 NY Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NY LICENSE 012498 01

Office Location

Street Address 2500 NESCONSET HWY
BUILDING 3C
City STONY BROOK
State NY
Zip Code 11790-2555

Providers in the same location

NPI Name Taxonomy Address Enumeration
1477556025 Marc Yland Anesthesiology 2500 Nesconset Hwy, Bldg 24c, Stony Brook, NY 11790-2598 2005-05-27
1417471202 Brandon M Henkowicz Dc, P.C. Chiropractor 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 2017-08-02
1902345846 Michael Fama Physical Therapist 2500 Nesconset Hwy, Bldg 22b, Stony Brook, NY 11790-2555 2017-02-13
1790149045 Three Village Orthodontics Dentist 2500 Nesconset Hwy, Building 6-b, Stony Brook, NY 11790-2555 2016-04-12
1790156008 Morgan Smyth Physician Assistant 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 2015-10-13
1679964043 Diana V Carney Nurse Practitioner 2500 Nesconset Hwy, Bldg 16, Suite 63, Stony Brook, NY 11790-2555 2015-02-06
1528469442 Stoney Brook Dental PC Dentist 2500 Nesconset Hwy, Suite 11, Stony Brook, NY 11790-2555 2014-09-10
1235545732 Robert Mosca Physical Therapy, Pllc Specialist 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 2014-07-03
1841606605 Shana Anthony Physical Therapist 2500 Nesconset Hwy, Stony Brook, NY 11790-2555 2014-07-01
1891136073 Comprehensive Neurology of Long Island PC Neuromusculoskeletal Medicine & OMM 2500 Nesconset Hwy, Bldg 5b, Stony Brook, NY 11790-2555 2013-07-16
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1649807678 Ribu Mathew Student in an Organized Health Care Education/Training Program Health Science Center T16, Room 020, Stony Brook, NY 11790 2020-03-27
1538794821 Chaoyang Qu Student in an Organized Health Care Education/Training Program 9 Syncamore Dr, Stonybrook, NY 11790 2020-03-06
1457814824 Brain & Spine Surgery, P.C. Neurological Surgery 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 2019-04-11
1447759741 Susan Cuccia Registered Nurse 40 Sheppard Lane, Stony Brook, NY 11790 2018-02-02
1972022234 Carol M Doherty Specialist 7 Haskel Lane, Stony Brook, NY 11790 2017-09-18
1972021582 Louren M Gonzales Nurse Practitioner 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 2017-09-04
1043740954 Asma Khattak Behavior Technician 90 Quaker Path, Stony Brook, NY 11790 2017-06-13
1427452846 Christina Georgia Registered Nurse 36 Ivy League Lane, Stony Brook, NY 11790 2014-10-14
1124361654 Mandeep Kainth Student in an Organized Health Care Education/Training Program Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 2013-04-03
1922357144 Audry M Luciano Registered Nurse 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 2012-09-04
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1255588414 Joyce Lorraine Quick Physician Assistant Stony Brook Univerity Medical Center, Suny @ Sb, Hsc Level 16, Room 080, Stony Brook, NY 11794-8167 2008-08-19
1013174861 Marlo Karen Dombroff Physician Assistant University Associates In Ob Gyn Ufpc, Stony Brook Cancer Center, Stony Brook, NY 11794-8091 2008-05-20
1619140738 Bridget A Pellegrini Physician Assistant Suny At Stony Brook Level T9, Stony Brook, NY 11794-8430 2008-04-09
1649395229 William Richard Gray Physician Assistant 2500 Nesconset Hwy Bldg 15h, Stony Brook, NY 11790-2554 2007-03-20
1386773406 Marlon T. Munian Physician Assistant Health Sciences Tower Level 3 086, Stony Brook, NY 11794-0001 2007-03-05
1306494133 Roshan T. Varughese Physician Assistant 101 Nicolls Rd Dept Of, Stony Brook, NY 11794-0001 2019-08-26
1003250622 Christine Frances Campagna Physician Assistant 6 Technology Dr, Stony Brook, NY 11794-9254 2013-04-25
1609174796 Monique Contento Physician Assistant 100 Patriots Rd, Stony Brook, NY 11790-3318 2011-03-14
1487962023 Diana C Santori Physician Assistant Stony Brook University Medical Ctr, Stony Brook, NY 11794-8122 2010-09-16
1518127018 Dona Angela Pellegrino Physician Assistant Stony Brook University Medical Ctr, Stony Brook, NY 11794-0001 2008-06-10
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Competitor

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City STONY BROOK
Zip Code 11790

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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